Early Detection of Breast Cancer: Strecker Breast Clinic Can Help
Listen in as Rajendra Bhati, MD discusses the the importance of early detection of breast cancer.
Transcription
Melanie Cole (Host): When it comes to breast cancer, early detection is key to better treatment and better outcomes. My guest today is Dr. Rajendra Bhati. He is a surgical oncologist with Memorial Health System. Welcome to the show, Dr. Bhati. How important is early detection of breast cancer?
Dr. Rajendra Bhati (Guest): Good morning. Thank you for having me on the show. Early detection is key and I think that we’ll find in many different sources, depending on who you talk to, that a good self-breast-examination as well as any mammography for average risk women starting at 40 is what most of the societies will recommend.
Melanie: I would like to go back for a second to self-examination. Give us just a little bit of a lesson because women don’t always know what it is they’re supposed to be feeling for. There’s lumps and things that are always different and changing. What are we supposed to be doing?
Dr. Bhati: That’s a good question. We find that oftentimes benign lesions of breast will trigger worrisome states for women when doing the self-breast examination, and it’s a fundamental practice on whether or not the recommendation should be formal, that a self-breast-examination should be done, because it needs to be done in the appropriate clinical context. I do recommend them personally, but I think that you’ll find that, depending on who you ask, that it will vary widely. I think that it is beneficial just because each individual woman will know her breast and, really, what you worry about are changes. You can recommend doing them at least every month, usually in the shower is when a lot of women choose to do them. You can either do them as a side-to-side motion on the breast, what’s called the lawn mower technique, or you can do them in them in a radio fashion just going from the middle of the breast, expanding out, kind of like spokes on a wheel, and looking largely for any changes. Frequently, cysts of the breast or benign lumps of the breast will present as masses and can be worrisome, but changes from the baseline is really the key end goal for early detection of breast cancer.
Melanie: You mentioned mammograms starting at age 40, how often after that?
Dr. Bhati: Usually every year. You’ll find that that even stays true for women have a personal history of breast cancer. It is done even on an annual basis.
Melanie: Tell us what happens after the mammogram. If something suspicious is found, then women hate that wait. It’s very hard, Dr. Bhati. So, what do you tell women every single day about what comes next?
Dr. Bhati: Sure. What’s really important and what really can assuage fears and really, I think, separate different delivery systems is whether or not there is a breast program in place specifically dedicated to serve women who are facing an abnormal mammogram. Here at Memorial, we have a specific breast imaging dedicated department where they can take you from an abnormal screening mammogram, all the way to invasive biopsies and complex imaging modalities, including breast MRI and digital mammography. Throughout that entire process we’ve dedicated a navigator that will specifically guide every woman through the process should she be faced with an abnormal mammogram. Usually, when an abnormal screening mammogram occurs, additional imaging is warranted, whether or not it’s additional imaging views via mammography versus ultrasound, or via breast MRI. And, sometimes that’ll lead to an invasive biopsy. And our navigator, who is fantastic at this, is really able to coach patients through it, along with the breast radiologist, through this entire process, and, in many cases, can go from an abnormal screen mammogram to biopsy even within the same day. So, it’s really nice. I think nationwide you’ll find that even with dedicated breast centers, the average time from screening mammography to biopsy is about 14 days, but here at Memorial, we’re averaging about 7 days from screening mammogram to biopsy, which is something we’re really proud of.
Melanie: Dr. Bhati, tell us about your team at Strecker Breast Clinic. Who else is involved besides the nurse navigator?
Dr. Bhati: This is another thing that I really am proud of, is that once a woman is faced with that breast cancer diagnosis, there are so many moving parts that have to become in sync and in coordination to execute her care. And so, what you’ll find is oftentimes in systems that aren’t coordinated, that a patient will see a medical oncologist or radiation oncologist or a surgical oncologist, and will have to do a round-robin, so to speak, with visiting all these different specialists, and oftentimes that can take weeks if not even months to occur. And that represents a delay in care. So, instead of the traditional model where the patient goes to see the physician, what we wanted to create here is where the physicians come to the patient. So, we’ve designed a specific multidisciplinary breast clinic to focus specifically on these patients to where they have the opportunity to meet with the medical oncologist, the radiation oncologist, the surgical oncologist. On top of that are the navigators, the social workers, the patient financial advocates, and visit with our resource team, our therapists. And, it really is a chance all in one setting to see all the resources that we have devoted specifically to care for a woman faced with breast cancer. So, we essentially boil it down into one morning what previously had taken many weeks. So, you’ll find that it’s reflective of what has happened on the diagnostic side of things where we could take a woman from abnormal mammogram to biopsy very quickly. Once that breast cancer diagnosis is established, we can take that newly diagnosed breast cancer patient through the entire treatment process and coordinate that for them. This is tied to our multidisciplinary breast tumor board, which is where all the specialists and ancillary staff sit down and discuss the unique aspects of every case and then, we deliver recommendation at the end of this tumor board to the patient together as a consensus group. I think that you’ll find that that offers a number with advantages because we all know that each patient is unique and all of our perspectives are different at times and, as a group consensus, that maximizes outcomes, minimize errors. I think that the patients find it most beneficial that way and certainly we do on the treatment and clinical side of things.
Melanie: Dr. Bhati, as a surgical oncologist, what’s new? What’s really exciting in the world of breast cancer?
Dr. Bhati: Oh, gosh, there’s so much to talk about. What I’ve always appreciated the most, of breast cancer specifically, is that the amount of information is overwhelming. But I think the reason why it’s so overwhelming is because there are so many good options. And those options vary from breast conservation lumpectomies to genetic testing, to complex reconstructive options from our plastic surgery team. I think, at times, it can be overwhelming but at the same time it’s also nice that we can tailor what’s a very complex sea of information and find that unique treatment plan that best helps the breast cancer patient. So, I am most excited whenever I sit down to know that it’s not going to be a one-size-fits-all approach to an individual patient, but rather my biggest challenge is to find out what treatment is best suited for that particular woman.
Melanie: And, why do you tell women to come to Memorial Health System for their care?
Dr. Bhati: I think we have a lot to be proud of compared to recently, I think there is no comparison to what we’re able to offer. As we just mentioned, the diagnostic modality is streamlined, the delivering mechanism is streamlined with our multidisciplinary breast clinic, our tumor boards are all done prospectively prior to initiation of any treatment and with all the experts at the table. We’re the only NABP CE accredited program in the region, as well as accredited by The American College of Radiology for Breast Imaging as well. So, I think it’s unique, it’s expedited, it’s organized, and it really has a lot of resources devoted to caring for the specific breast cancer patient. And, it’s not anything that you’ll find within two to three hours of driving distance from us locally.
Melanie: Thank you so much for being with us today, Dr. Bhati. You’re listening to Memorial Health Radio, and for more information you can go to www.MHsystem.org, expect more. This is Melanie Cole.
